Perioperative Management of Dental Surgery Patients Chronically Taking Antithrombotic Medications.

The development of medicine is based not only on the introduction of new methods of treatment, but also on the use of increasingly effective drugs, including antithrombotic drugs. Drugs that inhibit the activity of platelets (antiplatelet and anti-aggregating drugs) and pharmaceuticals that inhibit the activity of plasma coagulation factors (anticoagulants) are used in antithrombotic therapy. In our daily practice we encounter patients who take chronic antiplatelet or anticoagulant drugs. However, more and more often we are dealing with patients who are treated with two antiplatelet drugs, an antiplatelet and an anticoagulant or even undergoing triple antithrombotic therapy. When preparing the patient for invasive craniofacial procedures, it should be assessed whether the temporary discontinuation of antithrombotic treatment due to the fear of excessive perioperative bleeding is justified and will not result in life-threatening thromboembolic complications. The authors discuss in detail the medications used in modern antithrombotic treatment and present a perioperative management procedure with a patient who takes l4 z of these medications chronically.

Oral Mucosa Status and Saliva Parameters of Multimorbid Adult Patients Diagnosed with End-Stage Chronic Kidney Disease.

There has been an increasing number of patients diagnosed with chronic diseases. Many of those diseases determine changes in patients' social and even professional life. The aim of the present work was to analyze saliva and oral mucosa parameters in adult patients diagnosed with chronic diseases. A total of 228 patients took part in the research. A total of 180 patients were hemodialyzed in Diaverum dialysis stations, and there were 48 patients from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry of Silesian Medical University in Bytom and patients from the dentistry division of the Arnika Clinic in Zabrze not diagnosed with any such diseases. Selected saliva parameters (secretion, pH and buffer capacity) and mucosa status were examined. In order to obtain information regarding xerostomia, patients were given a questionnaire. Patients assigned to the control group rarely used water to make swallowing easier or used candies to lessen the feeling of oral cavity dryness. They also rarely suffered from eye dryness. The feeling of dryness also did not influence their social life. The amount of produced saliva was higher in the control group. There was a significantly lower percentage of patients with a low buffer capacity of saliva. There were no differences in terms of saliva pH values between the two groups of patients. A significantly lower number of patients were diagnosed with ecchymosis, candidiasis, scrotal tongue and mechanical damages. Patients diagnosed with chronic diseases need to be provided with long-term care.

Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students.

BACKGROUND: Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures. METHODS: A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I-Diagnosis, II-Caries Treatment, and III-Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0-6, where 0 indicates no stress, while 6 indicates high stress. RESULTS: Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures. CONCLUSION: Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

Oral microbiota in children with type 1 diabetes mellitus.

INTRODUCTION: The oral cavity is a unique ecosystem in which the microbiome is formed by the colonization of billions of bacteria, viruses, and fungi. Aim of the study was to assess the quality and quantity of bacterial microbiota of the oral cavity in children with type 1 diabetes in comparison to healthy children. MATERIAL AND METHODS: The study group consisted of 50 randomly selected type 1 diabetic children aged 10-18 years divided into 2 groups (25 people each) according to the level of diabetes control: well-controlled group (WC) - HbA1c ≤ 7.5%) and poorly-controlled group (PC) - HbA1c > 7.5%. The control group (GC) consisted of 25 randomly selected children with no systemic diseases. The material for microbiological tests was collected as two swabs: one from the bottom of the oral cavity and the other one from the posterior part of the dorsum of the tongue). RESULTS: The statistical analysis revealed statistically significant differences in the total number of isolated microorganisms between PC and GC (post hoc test p = 0.003) and WC and GC (post hoc test p < 0.001). There were no statistically significant differences in the number of isolated microorganisms between PC and WC (p = 0.195). CONCLUSIONS: Oral microbiome in type 1 diabetic children is significantly quantitatively different in comparison to healthy children. There are also visible qualitative differences in the profile of oral microbiota in type 1 diabetic children and healthy children.

Periodontal Treatment Needs of Hemodialized Patients.

End-stage renal failure is the reason for complications in many systems and organs, and the applied pharmacotherapy often causes the deepening of already existing pathologies within the oral cavity, such as: caries, periodontal diseases, mucosal lesions or reduced saliva secretion. Reduced saliva secretion results in an increased accumulation of dental plaque, its mineralization and prolonged retention, which leads to the development of gingival and periodontal inflammation. There is some evidence that chronic kidney diseases are influenced by periodontal health. The aim of the work was to evaluate the dental needs by the usage of clinical assessment of periodontal tissues of patients suffering from end-stage chronic kidney disease, arterial hypertension or/and diabetes mellitus. MATERIAL AND METHODS: 228 patients underwent the research. 180 patients were hemodialized in Diaverum dialysis stations (42 of them were diagnosed with end stage chronic disease, 79 with the end stage chronic disease and arterial hypertension, 16 with end stage chronic kidney disease and diabetes, 43 with end-stage chronic disease, arterial hypertension and diabetes) and 48 patients of the Conservative Dentistry with Endodontics Clinic of Academic Centre of Dentistry of Silesian Medical University in Bytom and patients of the dentistry division of Arnika Clinic in Zabrze not diagnosed with any of the aforementioned diseases. The scheme of the research comprised 2 parts: analysis of the general health and assessment of the periodontal status which contain the following indices: Periodontal Probing Depth (PPD), Clinical Attachment Lost (CAL), Bleeding Index or Bleeding on Probing Index (BI or BOP), Community Periodontal Index for Treatment Needs (CPITN). RESULTS: Significantly lower percentage of patients with healthy periodontal tissues and higher percentage with periodontal pockets deeper than 3.5 mm and the loss of trainers connective of 5 mm or higher were in the examined group. The values of the bleeding index were significantly lower in control group. The analysis of the CPITN index indicates higher percentage of patients qualified as CPI 1 or 2 in the control group while in the examined one most of the patients turned out to require specialist periodontal treatment. CONCLUSIONS: there is a direct relationship between periodontal status and end-stage renal disease which typically includes other chronical civilization ailments. It is important to develop a scheme for the easy and rapid examination of periodontal status, to determine the treatment needs in this area, which will allow precise assignment of long-term dialyzed patients to the range of prophylactic and therapeutic procedures.

Oral Status in Pregnant Women from Post-Industrial Areas of Upper Silesia in Reference to Occurrence of: Preterm Labors, Low Birth Weight and Type of Labor.

Increased levels of steroid hormones, action of local irritants and the lack of proper hygiene measures are of great importance in the development of dental caries, gingivitis and inflammation of the periodontal area in pregnant women. The aim of the study was to evaluate the state of oral hygiene and the periodontal area is such a population and assess the effectiveness of performed hygiene treatments and analyse changes in hygiene habits after oral hygiene instructions. The study was performed in two parts on a group of 50 pregnant women. The first part took place between the 14th and 17th week of pregnancy. The control study was conducted between the 27th and 30th week of pregnancy. Patients were subjected to a dental examination. Poor oral hygiene was observed among the examined patients. After the first examination, oral hygiene instruction was provided to 25 randomly selected pregnant patients. The effect of periodontal diseases on the time of labor was observed. Oral hygiene instructions significantly affected the state of the periodontal area of pregnant women for whom it was performed. It was confirmed that the advancement of pregnancy influences deterioration of the periodontium and also term of childbirth. Undoubtedly, pregnant women receive insufficient dental care. Priority should be given to dental care education of for pregnant women and alleviating the impact of oral diseases on the organism of a pregnant woman.

The Influence of Gender and Year of Study on Stress Levels and Coping Strategies among Polish Dental.

Background and objectives: Stress is a common term used to describe various adverse psychological conditions. Students in the dentistry field face many negative psychological outcomes. The core factors for stress among dental students are related to their training course and social contacts with peers. This research aimed to assess the stress of dental students depending on their gender and study year. Materials and methods: We used the Perceived Stress Scale (PSS-10) and Mini-COPE questionnaire. The surveys were conducted among 446 dental students (320 women and 126 men) at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice. Results: For the second-year and fifth-year students, the differences in scores were statistically significant, while in both cases, men had significantly lower values on the analysed scale. The results of the Kruskal-Wallis test indicated significantly lower values on the PSS-10 scale for the third-year and fourth-year students than in first-year students. The performed statistical analysis of the data obtained from the Mini-COPE questionnaire showed significant differences between men and women in individual years of study. In the first year, women chose more often the strategies related to turning to religion (p = 0.007), seeking emotional support (p = 0.046), seeking instrumental support (p = 0.045) and dealing with something else (p = 0.029) in coping with stress than men. Conclusions: The highest level of stress was found among first-year dental students. Moreover, women were characterised with higher stress levels than men. Men more often use psychoactive substances and resort to a sense of humour to cope with stress. On the other hand, women turn to religion, seek instrumental and emotional support.

Oral cavity status of long-term hemodialized patients vs. their socio-economic status.

BACKGROUND: The chronic kidney disease, blood hypertension and diabetes are recognized as civilization diseases that affect more and more people. The probability of encountering a patient suffering from these diseases is increasing. As such, it appears crucial to better understand the specific dental needs of such groups of patients. The aim of the work was to assess the oral hygiene status and the needs of patients suffering from the end-stage chronic kidney disease, arterial hypertension or/and diabetes. MATERIAL AND METHODS: Two hundred and twenty eight patients were included in the research. One hundred and eighty patients were hemodialized in Diaverum dialysis stations and 48 patients were from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry in Bytom, Silesian Medical University in Katowice, and from the Dentistry Division of the Arnika Clinic in Zabrze, and were not not diagnosed with any of the diseases mentioned. The research scheme was divided into 3 parts, consisting of an analysis of the general health socio-economic status, a survey and an assessment of oral health. RESULTS: The patients who were not suffering from any of the discussed diseases were more aware of how to properly perform hygienic procedures. Most of the patients from both the control and examined groups were not using any rinsing solutions. A higher percentage of patients in the control group was using dental floss, changing their toothbrush every 3 months and brushing their teeth for ≥2 min. The Aproximal Plaque Index and the Oral Hygiene Index-Simplified values in the control group were significantly lower in comparison to the examined group. CONCLUSIONS: The socio-economic status of hemodialized patients was low, which in most cases was a result of the difficulties in starting a job. Due to the lower standards of life, the neglect of oral hygiene maintenance and its consequences could be observed. Med Pr. 2020;71(3):279-88.

Evaluating the stress-response of dental students to the dental school environment.

INTRODUCTION AND OBJECTIVE: Dentists experience high amounts of professional stress beginning with their student years in dental school. This stress, given its early onset, may negatively impact the personal and professional lives of these individuals, as well as the quality of their clinical work. We sought to create an objective scale to evaluate the levels of stress in students at different stages of their education, as well as in practicing physicians. MATERIALS AND METHODS: Thirty dental students participated in this study, with 10 students each selected from junior, mid-senior, and senior classes. They were randomly divided into two groups in which one group was subjected to stressors while the other group was not. JINS MEME ES_R (JINS) smart glasses and Garmin Vivoactive 3 smartwatches were used to obtain data, including electrooculography (EOG), heart rate (HR), and accelerometer (ACC) and gyroscope (GYRO) feedback, while the subjects performed a dental exercise on a phantom tooth. RESULTS: The heart rates of more experienced students were lower than those of the junior students. The EOG, ACC, and GYRO signals showed multiple differences in the measurement of amplitudes and frequency of episodes. CONCLUSION: Our pilot results show that electronic tools, like smart glasses with software and sensors, are useful for monitoring the stress levels of dental students in preclinical operating conditions. We would like to further assess the stress levels in students performing dental procedures on phantom teeth and in later clinical interactions with patients.

Dental caries and periodontal status in children with type 1 diabetes mellitus.

INTRODUCTION: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that strongly affects the health of individuals. Some studies have sug-gested that it affects oral health, thus indicating a higher-than-average predisposition of patients with diabetes to caries and periodontal diseases. AIM OF THE STUDY: We aimed at investigating the association between caries, periodontal diseases, and diabetes among children using dental indices. MATERIAL AND METHODS: The study included 50 children (aged 10-18 years) who had type 1 diabetes for at least years. The participants were divided into well controlled (WC), (HBA1c < 7.5%) and poorly controlled (PC) (HBA1c ≥ 7.5%) groups (25 diabetic children each). The control group (GC) included non-diabetic children. The following clinical parameters were measured: DMFT index, plaque index (PI), approximal plaque index (API), gingival index (GI), and modified sulcus bleeding index (mSBI). RESULTS: The WC group had the lowest average value - 3.44 of the DMFT index with values of 5.80 and 3.88 in the PC and GC groups, respec-tively. A statistically significant difference was found in the DMFT value between PC and WC groups (p = 0.04). No statistically signif-icant differences in the values of other indices were found between the groups. CONCLUSIONS: Children with poorly controlled type 1 diabetes were characterised by a significantly higher intensity of caries. In contrast, no statistical-ly significant differences were observed in the periodontal status between the study groups.

Gender related changes of empathy level among Polish dental students over the course of training.

The appropriate approach to dental patients, developed during the course of dentists' training, is a prerequisite for the holistic treatment of patients. Empathy is an important component of such an approach. This study aimed to determine the levels of empathy among students of dentistry at different stages in their training.The Jefferson Scale of Empathy - Health Profession Students Version was used to conduct the research, and 100 dental students (66 female and 34 male) ranging from first to fifth year participated in the survey. The scale contained 20 questions, with a possible score interval between 20 and 140. A higher score indicates increased ability to express empathy.The level of empathy among dentistry students increased from the first and second to fourth years, where it reached its maximum. During the fifth year, a decrease in levels of empathy was observed.The increase in empathy during the dental course may be correlated with the growth of clinical practice during the subsequent years of study. A slight decrease in empathy in the fifth-year students may be due to the curricular focus on performing procedures, with students having to meet a set target in order to finish the course.

Empathy amongst dental students: An institutional cross-sectional survey in Poland and Croatia.

AIM: To determine and compare levels of empathy and its dimensions in Polish and Croatian dental students. METHODS: Fourth- and fifth-year dental students (N = 193) at the University of Rijeka and University of Silesia completed questionnaires to determine levels of overall empathy and its dimensions: compassionate care (CC), perspective taking (PT) and ability to stand in someone else's shoes (ASSES). Total empathy and its dimensions were analysed depending on the country of origin, year of study and gender of the participants. The HPS version of the Jefferson Scale of Physician Empathy was used to conduct the research. Statistical analysis was performed using the Mann-Whitney U test. RESULTS: The analysis showed no significant differences in total empathy level between Polish and Croatian students (P = .838). However, separate analysis of empathy items showed significant differences between the two groups. Croatian students obtained significantly higher average PT values (P = .021), whilst Polish students had significantly higher CC scores (P < .001). Analysis of Croatian respondents revealed significantly higher ASSES scores in the fourth- and fifth-year students (P = .047). Analysis in the Polish group demonstrated an increase in PT scores from the fourth to the fifth year of study (P = .008). CONCLUSION: Croatian students scored higher on items associated with cognitive empathy, whilst Polish students displayed higher values in the aspect of emotional empathy. The present results demonstrated an increase in cognitive empathy level in Polish students, whilst in their Croatian colleagues, the level of cognitive empathy decreased with the progression of the academic programme.